<!DOCTYPE html>
<html>
<head>
<meta charset="UTF-8">
<link rel="stylesheet" type="text/css" media="screen" href="../../css/bootstrap.min.css">
</head>
<body>
<div class="col-xs-12 col-sm-12 col-md-12 col-lg-12">
	<form class="form-horizontal" onsubmit="return false" id="form">
		<fieldset>
			<div class='form-group'>
				<label class='col-md-2 control-label'>fid</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='fid' type='text' name='fid' id='fid' data-bv-notempty='true' data-bv-notempty-message='fid 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>tradepaynoid</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='tradepaynoid' type='text' name='tradepaynoid' id='tradepaynoid' data-bv-notempty='true' data-bv-notempty-message='tradepaynoid 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>outtradeno</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='outtradeno' type='text' name='outtradeno' id='outtradeno' data-bv-notempty='true' data-bv-notempty-message='outtradeno 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>authcode</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='authcode' type='text' name='authcode' id='authcode' data-bv-notempty='true' data-bv-notempty-message='authcode 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>totalamount</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='totalamount' type='text' name='totalamount' id='totalamount' data-bv-notempty='true' data-bv-notempty-message='totalamount 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>subject</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='subject' type='text' name='subject' id='subject' data-bv-notempty='true' data-bv-notempty-message='subject 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>hostcode</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='hostcode' type='text' name='hostcode' id='hostcode' data-bv-notempty='true' data-bv-notempty-message='hostcode 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>refundno</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='refundno' type='text' name='refundno' id='refundno' data-bv-notempty='true' data-bv-notempty-message='refundno 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>notifyid</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='notifyid' type='text' name='notifyid' id='notifyid' data-bv-notempty='true' data-bv-notempty-message='notifyid 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>notifytime</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='notifytime' type='text' name='notifytime' id='notifytime' data-bv-notempty='true' data-bv-notempty-message='notifytime 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>buyeremail</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='buyeremail' type='text' name='buyeremail' id='buyeremail' data-bv-notempty='true' data-bv-notempty-message='buyeremail 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>selleremail</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='selleremail' type='text' name='selleremail' id='selleremail' data-bv-notempty='true' data-bv-notempty-message='selleremail 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>gmtcreate</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='gmtcreate' type='text' name='gmtcreate' id='gmtcreate' data-bv-notempty='true' data-bv-notempty-message='gmtcreate 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>batchno</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='batchno' type='text' name='batchno' id='batchno' data-bv-notempty='true' data-bv-notempty-message='batchno 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>gmtrefund</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='gmtrefund' type='text' name='gmtrefund' id='gmtrefund' data-bv-notempty='true' data-bv-notempty-message='gmtrefund 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>refundstatus</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='refundstatus' type='text' name='refundstatus' id='refundstatus' data-bv-notempty='true' data-bv-notempty-message='refundstatus 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>applypeople</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='applypeople' type='text' name='applypeople' id='applypeople' data-bv-notempty='true' data-bv-notempty-message='applypeople 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>applyphone</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='applyphone' type='text' name='applyphone' id='applyphone' data-bv-notempty='true' data-bv-notempty-message='applyphone 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>applysocial</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='applysocial' type='text' name='applysocial' id='applysocial' data-bv-notempty='true' data-bv-notempty-message='applysocial 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>patientname</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='patientname' type='text' name='patientname' id='patientname' data-bv-notempty='true' data-bv-notempty-message='patientname 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>patientsex</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='patientsex' type='text' name='patientsex' id='patientsex' data-bv-notempty='true' data-bv-notempty-message='patientsex 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>patientsocial</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='patientsocial' type='text' name='patientsocial' id='patientsocial' data-bv-notempty='true' data-bv-notempty-message='patientsocial 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>patientphone</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='patientphone' type='text' name='patientphone' id='patientphone' data-bv-notempty='true' data-bv-notempty-message='patientphone 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>orderstatus</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='orderstatus' type='text' name='orderstatus' id='orderstatus' data-bv-notempty='true' data-bv-notempty-message='orderstatus 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>feestatus</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='feestatus' type='text' name='feestatus' id='feestatus' data-bv-notempty='true' data-bv-notempty-message='feestatus 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>orderno</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='orderno' type='text' name='orderno' id='orderno' data-bv-notempty='true' data-bv-notempty-message='orderno 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>tradeno</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='tradeno' type='text' name='tradeno' id='tradeno' data-bv-notempty='true' data-bv-notempty-message='tradeno 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>orderdate</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='orderdate' type='text' name='orderdate' id='orderdate' data-bv-notempty='true' data-bv-notempty-message='orderdate 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>patientid</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='patientid' type='text' name='patientid' id='patientid' data-bv-notempty='true' data-bv-notempty-message='patientid 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>times</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='times' type='text' name='times' id='times' data-bv-notempty='true' data-bv-notempty-message='times 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>paytype</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='paytype' type='text' name='paytype' id='paytype' data-bv-notempty='true' data-bv-notempty-message='paytype 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>chequtype</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='chequtype' type='text' name='chequtype' id='chequtype' data-bv-notempty='true' data-bv-notempty-message='chequtype 不能为空'>
				</div>
			</div>


			<div class="form-actions">
				<div class="row" align="center">
					<div class="col-md-12">
					    <button class="btn btn-primary" onclick="location.href='appTradePaynoList.html'">返回</button>
						<button class="btn btn-primary" type="submit" onclick="add()">
							<i class="fa fa-save"></i> 保存
						</button>
					</div>
				</div>
			</div>

		</fieldset>
	</form>
</div>
	<script type="text/javascript" src="../../js/libs/jquery-2.1.1.min.js"></script>
	<script type="text/javascript" src="../../js/jq.js"></script>
	<script type="text/javascript" src="../../js/plugin/bootstrapvalidator/bootstrapValidator.min.js"></script>
	<script type="text/javascript" src="../../js/common.js"></script>
	<script type="text/javascript" src="../../layui/layui.js"></script>
	<script type="text/javascript">
		layui.use(['layer','laydate'], function(){
		    var layer = layui.layer;
		});
		
		function add() {
			$('#form').bootstrapValidator();
			var bootstrapValidator = $("#form").data('bootstrapValidator');
			bootstrapValidator.validate();
		    if(!bootstrapValidator.isValid()){
			   return;
		    }
		    
		    var formdata = $("#form").serializeObject();

			$.ajax({
				type : 'post',
				url : '/appTradePaynos',
				contentType: "application/json; charset=utf-8",  
				data : JSON.stringify(formdata),
				success : function(data) {
					layer.msg("添加成功", {shift: -1, time: 1000}, function(){
                        location.href = "appTradePaynoList.html";
                    });
				}
			});
		}
		
	</script>
</body>
</html>
